title: Prone versus supine position for adjuvant breast radiotherapy: a prospective study in patients with pendulous breasts.
abstract: OBJECTIVE
  To analyze dosimetric parameters of patients receiving adjuvant breast radiotherapy (RT) in the prone versus supine position.
  
  
  METHODS
  Forty-one out of 55 patients with pendulous breasts and candidates for adjuvant RT were enrolled in the study after informed consent. They underwent computed tomography (CT)-simulation in both prone and supine position. Target and non target volumes were outlined on CT images. Prescribed dose was 50 Gy delivered by two tangential photon fields followed by 10 Gy electron boost. Target coverage and dose homogeneity to clinical target volume (CTV) and planning target volume (PTV) were assessed by V95, V105 and V107 and dose to lung, heart and left anterior descending coronary artery (LAD) by V5, V10, V20, and mean and maximum dose. Data were analyzed by Student's t-test.
  
  
  RESULTS
  CTV and PTV coverage was significantly better in supine than in prone position. Lung V5, V10, and V20 were significantly lower in prone than in supine position. Heart V5, V10, V20, and LAD mean and maximum dose, in the 17 patients with left breast tumor, were lower in prone than in supine position, but without statistical significance. Based on treatment planning data and on treatment feasibility, 29/41 patients (70.7%) were treated in prone position. Acute and late toxicities of patients treated in prone and in supine position were not statistically different.
  
  
  CONCLUSIONS
  Prone position is a favorable alternative for irradiation of mammary gland in patients with pendulous breasts and in our series was adopted in 71% of the cases.
authors.affiliation: Department of Radiotherapy, University of "Piemonte Orientale", Via Solaroli 17, 28100 Novara, Italy. krengli@med.unipmn.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Krengli
authors.forename: Laura
authors.initials: L
authors.lastname: Masini
authors.forename: Tina
authors.initials: T
authors.lastname: Caltavuturo
authors.forename: Carla
authors.initials: C
authors.lastname: Pisani
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Apicella
authors.forename: Eleonora
authors.initials: E
authors.lastname: Negri
authors.forename: Letizia
authors.initials: L
authors.lastname: Deantonio
authors.forename: Marco
authors.initials: M
authors.lastname: Brambilla
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Gambaro
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016684:Prone Position; D011446:Prospective Studies; D011874:Radiometry; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D016683:Supine Position